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AIDS-related cholangiopancreatographic changes
J Farman1, J Brunetti, J W Baer
1Department of Radiology, Columbia-Presbyterian Medical Center, New York, NY 10032-3284.
Abdominal Imaging
|September 1, 1994
Summary
Acquired immunodeficiency syndrome (AIDS) associated cholangitis presents with distinct radiographic findings, including biliary duct abnormalities and strictures. Opportunistic infections are common in these patients.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Cholangitis is a serious biliary tract infection.
- Acquired immunodeficiency syndrome (AIDS) can predispose individuals to opportunistic infections affecting the biliary system.
Purpose of the Study:
- To evaluate the cholangiographic and pancreatographic appearances of AIDS-associated cholangitis.
- To identify common radiographic findings and associated infections in patients with AIDS-related biliary disease.
Main Methods:
- Retrospective review of cholangiographic and pancreatographic studies in 26 patients with AIDS.
- Diagnostic imaging included endoscopic retrograde cholangiopancreatography (ERCP), T-tube cholangiography, and transhepatic cholangiography.
- Microbiological analysis of bile and gallbladder tissue.
Main Results:
- Radiographic findings included intrahepatic ductal abnormalities and extrahepatic biliary tree involvement (8 patients), or ampullary/common bile duct strictures with proximal dilatation (18 patients).
- Six of 12 patients had juxta-ampullary pancreatic duct strictures.
- Twenty-one patients had infections with Cryptosporidium, Mycobacterium avium intracellulare, cytomegalovirus, Microsporidium, or Isospora.
- Three patients underwent surgery for acute acalculous cholecystitis, with organisms identified in bile and gallbladder.
Conclusions:
- AIDS-associated cholangitis exhibits characteristic cholangiographic and pancreatographic features.
- Opportunistic infections are frequently implicated in the pathogenesis of AIDS-related cholangitis and cholecystitis.
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